Ed Gogek, M.D.
I’ve been a psychiatrist for 30 years and have worked in prisons, homeless clinics, and mental health centers. For years I also had my own private practice and consulted for several substance abuse treatment centers. Because I did extra child training in residency, the rural areas where I’ve worked made me the default child and adolescent psychiatrist. However, one of my biggest interests has been addiction psychiatry.
Doctors are nerds who are fascinated by disease. Often we have one disease that really excites us. After 30 years, I still like interviewing addicts and alcoholics. Which is good, because there are a lot of them.
What fascinates me most about addiction is that we are dealing with people whose main symptom is that they lie, and often don’t even know they are lying. Treatment isn’t just getting people to stay away from drugs and alcohol; anyone can do that, at least for a while. Treatment is helping people to stop lying, particularly to themselves. To me, the biggest part of the job is helping addicts, alcoholics and their family members see past their own denial.
My own belief, based on experience, is that every addict or alcoholic is happier clean and sober. But convincing them is another story. I also believe legalizing pot, or legalizing all drugs, would be bad for the country. A nation also is much happier clean and sober.
I’m writing this blog because two things support the marijuana movement and make it possible. First are the dishonest arguments we hear from the marijuana lobby—arguments that are not very different from the rationalizations I hear from my addicted patients in the throes of denial. Addicts often say the exact opposite of what is true, and I see that with the pro-marijuana arguments as well. Second is a news media that seems to have largely bought the marijuana lobby line. However, I don’t think most journalists see how slanted the press has been.
So writing this blog is not too different from the work I’ve been doing for the past 30 years. I’m trying to help people see past their denial.
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I get all sorts of accusations, so let me answer some of them. I do not make any money from my anti-drug political activity. I’m doing it because it makes no sense to help one person at a time in my office while the country is adopting policies that will harm millions.
I don’t make my living from drug abusers ordered into treatment. The treatment programs I work for treat only voluntary patients. Legalization would actually increase addiction and bring me more patients—which I don’t need.
I do work in a prison, and at least two-thirds of inmates are substance abusers. But it’s a myth that drug laws are swelling our prison population. Most prison inmates are there for things they did because they were drunk or high, and legalization would only increase that type of crime and again give me more business–which, again, I don’t need. Besides, I am no fan of our criminal justice system which provides almost no treatment and often imposes inappropriately long sentences.
I’m also no fan of Big Pharma, either, and have never worked for them or accepted their money. I used to go to the dinners they sponsored, but over the past ten years, I’ve only accepted drug samples that I gave to patients with no insurance and I once accepted a textbook that I gave to a student. In my private practice I use a lot of alternative medicine, and my aim is to help people get off medication–especially addictive medication.
Politically, I’m a moderate Democrat—very liberal on economic and environmental issues, more moderate on social ones. My first vote at age 18 was for George McGovern and I’ve voted nearly straight Democratic ever since. The exceptions were Barry Commoner for President in 1980 and helping to vote Rhode Island Congressman Fernand St Germain out of office in 1988. As a teenager I caught the tail end of the Vietnam protests, but was much more involved in the anti-nuclear power movement in the late 70s.
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People ask why I’m opposed to legalization, and it’s pretty simple: The push by both the marijuana lobby and the news media to convince people marijuana is harmless has resulted in a huge increase in teenage use. This pro-marijuana chatter combined with legalization could lead to 100,000 of our current teens dropping out of school and over a million doing worse in school and underperforming in life. There is no way to legalize pot for responsible adults and not have it also available to teens. And what sort of responsible adult is so selfish that he’d demand his right to pot even if it hurt a million kids? It’s a drug of abuse, not one of life’s necessities.
Also, normalizing marijuana use encourages a druggie culture, and druggie culture is cynical, alienated and tolerates dishonesty. The most obvious example of this cynicism and dishonesty is the way “medical” marijuana laws teach kids to lie–they see parents, teachers and other adult role models faking illness to get a marijuana card and they grow up believing that’s the right way to deal with the world.
I don’t like defending alcohol, but a large number of Americans use alcohol socially – for the taste and companionship. People smoke pot for only one reason–to get stoned, a.k.a. wasted, f-‘d up. Our culture approves of genuine social drinking but frowns on people who drink to get drunk. Smoking weed to get wasted is no different from drinking to get drunk. It took us decades and the help of MADD to get America to stop indulging and ignoring alcoholic behavior. Are we now going to start indulging stoner culture?
My suggestions for the country on how to handle pot are: Stop pretending drug abuse is okay; it’s not, and most marijuana use is drug abuse. Stop pretending people are going to smoke pot no matter what; we know marijuana use goes way up and down depending on how harmful people think it is. Stop pretending that otherwise innocent people are being arrested and locked up for nothing but pot; they aren’t. Stop pretending that “medical” marijuana laws are medical; they are almost entirely for drug abuse.
Drug abuse is a disease, but the main symptom is that sufferers insist they don’t have a disease and don’t want treatment. That Amy Winehouse song, “They tried to make me go to rehab, but I said, ‘No, no, no,’” is how every addict and alcoholic feels. My experience is that once drug abusers are forced to get clean and sober, they are usually grateful. But they have to be coerced into treatment, and we can use the law to do it. It’s not punishment; it’s how you help someone who is deluded and in denial. Believing their delusions and supporting their denial is called enabling. Enabling drug abusers does not help them; instead, it keeps them sick, and that is no favor.
From my point of view, the marijuana lobby represents drug abusers, their demand for legalization is the typical drug abuser wish to be left alone while they continue their drug use, and the politicians and journalists who support them are enablers.
I don’t support either the war on drugs or legalization. I favor a recovery-based program of coerced treatment and recovery. Iinstead of decriminalization, I favor destigmatization. Here’s how ti works. Use every means possible to coerce addicts and alcoholics into getting clean and sober and into recovery, and that includes keeping our strict drug laws. But once someone has been clean and sober for two or five or some other number of years, erase any record and forbid asking about it when people apply for jobs, permits, etc. We need those laws to get addicts into treatment and into recovery. But it makes no sense to call it a disease and then punish people who have gotten treatment and are clean and sober. Punishment should be a consequence for people who refuse to get treatment, not for people who recognized the disease and dealt with it responsibly.
Thanks for reading this and I hope you find the blog useful.
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Op-Eds I’ve written on marijuana
New York Times: http://www.nytimes.com/2012/11/08/opinion/a-bad-trip-for-democrats.html?_r=1&
Baltimore Sun, before I knew that “medical” weed was a scam: http://articles.baltimoresun.com/2002-01-27/news/0201260157_1_marijuana-users-regular-marijuana-addiction
Arizona Republic, evidence that “medical” pot is a scam: http://www.azcentral.com/arizonarepublic/opinions/articles/2011/08/04/20110804gogek05-medical-pot.html
San Francisco Chronicle: http://www.sfgate.com/opinion/article/Medical-marijuana-a-health-risk-for-society-3498533.php
Arizona Republic: Carolyn Short’s idea, but I helped her write it. http://www.azcentral.com/arizonarepublic/opinions/articles/20110411gogek12.html